hss 4331 – international health jan 18, 2010 – crisis in haiti
TRANSCRIPT
HSS 4331 – International Health
Jan 18, 2010 – Crisis in Haiti
Message from Arif• 'there is good news and bad news. the bad news is that because I moved
this week even though I was almost finished marking the papers, they are not yet complete. Please expect the marks to be up during the week. This is preferable in fact, because if you have a concern about the mark and want to see me, I prefer to go over the comments with you. I will hand back the papers with comments on Monday.
• • The good news is that despite the early low average, the overall batch has
been better, the average is now 73-74. Secondly, we do have a plan to help those who did poorly to both improve your mark while getting a head start on the policy paper through an extra assignment. The assignment will not be graded, but if you prepare it we can transfer more marks onto the policy paper, lessening the blow for the exam. Moreover, you can use this assignment if you are getting assistance either from Ray or from Academic Writing Help Centre, or both - as you write the policy paper.
• • Work hard, enjoy life.'
Arif’s living room
Seminar Opportunity Today
• Mads Gilbert• “Eyes on Gaza”
• Fauteau 147B• 7:30-8:30pm
• Famous for criticisms of MSF
Jan 27, 2010730-9pmAlumni AudICDW Keynote Speaker
Dr Thomas Homer Dixon
Global security specialist
$10 students
Jan 29, 2010ICDW Guest Speaker: Nigel Fisher
President of UNICEF
7-9pmLocation TBD
http://www.scdi-icdw.uottawa.ca/
Many Questions Abound
• What are factors that made Haiti vulnerable?• What are barriers to providing Haiti aid?• What kinds of aid does Haiti need, in near and
long term?• What economic, political, ethical interests do
we have in Haiti?
Geography of Haiti
• “In Haiti Geography Is Destiny” –Ellen Ratner• Haiti is the Western third of the island of
Hispaniola• The other 2/3 is the nation of the Dominican
Republic• <100 miles from Cuba• Mostly rough, mountainous terrain• 28% arable land• Middle of the hurricane belt
Population of Haiti• About 9 million people• Median age is 18 • Life expectancy at birth = 53 years• HIV rate = ~6% (2003)• 53% literacy• Poorest country in Western hemisphere; 80% live
in abject poverty– Half live on $0.50 per day
• 2/3 depend on agriculture, mainly small scale subsistence farming
Economy of Haiti
• Major trading partners: USA, DR, Canada• $1.2 billion debt• Known route for cocaine trafficking and
money laundering• Resources: bauxite, copper, calcium
carbonate, gold, marble, hydropower
History of Instability
• 1492: Christopher Columbus reaches the island of Hispaniola.
• 1697: Spain cedes the western part of the island to the France, which became a French colony known as St. Dominique. The colony becomes one of the richest in the Caribbean due to sugar-related industries.
• 1791: Revolution begins; thousands of slaves revolt against their owner. Revolt leads to a civil war. The slaves were led by Toussaint L'Ouverture. Fighting wages for 13 years
• 1804: General Jean Jacques Dessalines declares the country a republic and changes the name to Haiti, from the indigenous Taino-Arawak word for "mountainous country.“
• 1838: Haiti is finally recognized by the French government. Other European nations and the United States don't recognize the country in fear the slave revolt would spread to their shores
• 1862: The United States develops diplomatic relations with Haiti.• 1915: President Woodrow Wilson orders Marines to occupy Haiti and
take control of the ports. The Marines help to establish the Haitian National Guard.
• 1937: The U.S. withdraws.• 1957-1964: Years of political instability lead to the military-backed
election of Dr. Francois "Papa Doc" Duvalier in 1964. Dr. Duvalier declares himself president for life.
• 1971: Papa Doc Duvalier dies, and his son, Jean Claude, succeeds him.
• 1986: Protest against "Baby Doc" Duvalier leads to him being exiled to France and General Henri Namphy becoming the head of the National Governing Council.
• 1990: Presidential elections are held; Father Jean Bertrand Aristide is elected with 67.5% of the vote.
• 1991: Mr. Aristide tries to clean up Haiti from corruption but, upon returning to the country after speaking at the United Nations, a coup d'etat takes place and he is ousted. An embargo is launched against Haiti in response to the coup.
• 1992: Talks between the ousted Mr. Aristide and General Cedras take place in Washington.
• 1994: Mr. Aristide and his government in exile return to Haiti after an accord was signed in 1993.
• 1996: Rene Preval is sworn in as president.• 2000: Controversy over voting irregularities in regional
elections leads to a boycott of the presidential election. Mr. Aristide is elected president again.
• 2004: A rebel uprising leads to the resignation of Mr. Aristide and his exile to the Central African Republic. Chief Justice of the Haitian Supreme Court Boniface Alexandre is named interim president.
• 2006: Mr. Preval again is elected president.• 2000: US aid begins
Natural disasters• 2002- floods• 2003 –floods• 2004 – famine due to political demonstrations• 2004- hurricane Jeanne• 2005 – hurricane Dennis• 2006 – floods• 2007 – floods• 2008 – mass starvation affects 2.5 million• 2008 – four hurricanes• 2009 – series of tropical storms• 2010 - earthquake
How Do Earthquakes Affect Public Health?
• Falling buildings bury people• Destroy roads, airports, etc, hence prevent aid
from getting around• Destroy hospitals• Destroy water supply **• Destroy power generation and communications
capacity• Creates fear of infrastructure• Multiple crises, thus cannot concentrate
resources
Poverty
• If you live in squalor, you are more vulnerable to disasters
• Structures are more vulnerable• No personal or social safety net (no saved
food, fuel or money)• Environmental degradation?
An Earthquake is Nobody’s Fault?
• Thomas Jefferson once argued that Haiti was a bad example to the rest of the (slave-owning) world, and argued that it was necessary to “confine the plague to the island.”
• When the slaves wontheir independence in 1804, the French punished them by demanding payment for damages (the equivalent of $21.7 billion in today’s dollars, or forty-four times Haiti’s current yearly budget, according to journalist Eduardo Galeano)
• Aristide was ousted by US surrogates, re-educated to accept World Bank help, then re-positioned (by US marines) as Haiti’s leader when he agreed to allow World Bank structural adjustments
• And what about corruption?– “Forty percent of Haiti’s current debt was accrued
[personally] by the dictator Duvalier” – Marie Clarke
– Constant political violence and petty politics has prevented investment in food production and public health
What Aid is Needed?
• As with all natural disasters, the focus is on search and rescue and on emergency medical care
• However, in Haiti’s case one of the biggest crises is fresh water– Most humans can only live a couple of days
without water; injured humans need more
What Aid is Needed?
• “Luckily” food and medical stores were already in place outside the city for transport after the hurricanes, but blocked roads are preventing transport
• Priority focus on search and rescue activities will soon give way to infection control– Expect a new wave of mass deaths in a week’s
time as infections set in
Barriers to Providing Aid
• Haiti has one large airport that can handle transports, and five acknowledged airstrips
• Incoming aid planes are blocking the runways• Lack of fuel is preventing departures and
slowing transport of goods
Important skills -> machine operation and logistics
What Can We Expect?
• Once emergency phase has subsided, shelter will become a lingering concern
• Refugee camps are bad places– Crime– Infectious disease (TB?)– Mental health– Educational gaps– Agriculture neglected
What Can We Expect?
• Underservicing of chronic diseases• Exacerbated food and water issues (quantity
and quality)• Resulting decline and health status• Possible re-assertion of HIV issues as nutrition
and infrastructure prevent delivery and uptake of ARVs
What Can We Do?
• Send money– NGOs
• When news cycle ends, keep Haiti on the agenda